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I’ve been offered the COVID-19 vaccine. What do I do now?

The COVID-19 vaccine is another risk mitigation tool, kind of like ”internal body armor”

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Sgt. First Class Doreen Fajota gives Sgt. Brittany Koppenhaver a Moderna COVID-19 vaccine Tuesday, Dec. 22, 2020, at Evans Army Community Hospital as Fort Carson U.S. Army Base in Colorado Springs became the first military installation in Colorado to administer the vaccine.

Christian Murdock/The Gazette via AP, Pool

“In order to ensure that we acquire sufficient quantities of COVID-19 vaccines when they are made available to us, we are asking every employee to respond to this survey.”

Look familiar? Chances are you have recently gotten an email like this, and if not, you will get one soon.

You may be asking yourself:

  • “Do I take the COVID vaccine?”
  • “Is the COVID vaccine safe?”
  • “Should I wait?”
  • “Who and what should I believe?”

I’ll tell you what I think, as a doctor and a cop. This is my opinion – not department policy, not someone’s executive order and not me preaching at you – just a fellow officer who wants to share some facts to help you make your own decision.

First off. Who am I? Well, I’m an MD with a master’s in public health and board certification in occupational medicine. I’ve run travel health clinics and been responsible for force health protection for several overseas deployments with the Navy and Marine Corps. I’ve had most of the vaccines that are out there (some 2 or 3 times), and I’ve read and studied everything about COVID-19 that I could get my hands on over the past 11 months. I’m also a reserve deputy sheriff, serving in southern Colorado for the past 10 years. I’ve worked the road, the jail, crime scenes, wildfires, as well as other details and call outs. I have tremendous respect for all of you and the tough job you do every day, just as we all have great respect and admiration for the FTOs, DTOs and instructors that taught us things that could save our lives later. We listened to them because they had the years of experience and the hash marks, stripes and stars to prove it, so for the next few minutes, let me be your “COVID-19 FTO.”

What the statistics show

There have been over 330,000 deaths in the United States due to COVID-19 since the pandemic started. There have been reports of almost 200 to over 300 COVID-19 line-of-duty law enforcement deaths making the coronavirus the leading cause of police LODDs in 2020.

One of these deaths was a deputy who had been one of my instructors – a family man whose life was tragically cut short. If you read the biographies of those officers who have died, you’ll see hard-working men and women of all ages and ethnic groups from local, state and federal agencies, working patrol, detentions, corrections, investigations and other areas. There are many empty chairs at the dinner table and empty chairs at roll calls and briefings all due to a terrible virus that doesn’t discriminate about who it kills.

Despite this deadly threat, a recent Police1 survey showed that only 38% of LEOs surveyed planned to take the vaccine in contrast to 71% of the general public, according to the Kaiser Family Foundation. The current case fatality ratio for COVID-19 in the US is 1.8%, meaning that out of 1,000 people who get infected, 18 will die. Those who recover may have long-term side effects including fatigue, breathing difficulties, infections, blood clots, and heart, kidney, skin, neurologic and psychiatric problems. About 2% of people who recover from a COVID infection will report having symptoms that last longer than 12 weeks – AKA the “long haulers” – so that’s another 20 people out of the group of 1,000 mentioned before.

About the COVID vaccines

Two vaccines, Pfizer-BioNTech and Moderna, have been granted “Emergency Use Authorization” (EUA) by the FDA. They are currently being given to frontline medical workers and other individuals at high risk for exposure to COVID-19. There are other vaccines in the pipeline, too, but not yet authorized as of this writing.

Both vaccines went through accelerated clinical trials involving thousands of people, and they were judged safe and effective enough by the FDA for distribution to the public (per their labels). The vaccines are around 95% effective at preventing infection with COVID-19.

Since the vaccines are new, we do not know if there will be long-term side effects. I have two daughters and a pregnant daughter-in-law who are frontline hospital workers who were vaccinated (voluntarily) this past week, and all are doing fine.

Why is COVID-19 vaccine efficacy so much better than seasonal flu vaccines, which average only about 40%? Well, they had the COVID-19 virus “blueprint” before they began working on the vaccine, but for seasonal flu, they have to guess as to which 3-4 specific flu strains are going to be most prevalent, and sometimes they guess wrong.

The Pfizer-BioNTech and Moderna vaccines are “mRNA” vaccines, which according to the CDC, “give instructions for our cells to make a harmless piece of what is called the spike protein. The spike protein is found on the surface of the virus that causes COVID-19. Next, the cell displays the protein piece on its surface. Our immune systems recognize that the protein doesn’t belong there and begin building an immune response and making antibodies, like what happens in natural infection against COVID-19.”

There is no live virus in the vaccine and you absolutely cannot be infected with COVID-19 by taking it. The mRNA does not incorporate into your own DNA, and although this is the first mRNA vaccine authorized for use in humans in the US, medical experts have been researching them for years and planned to use them for a pandemic just like this one. Operation Warp Speed and desperate times accelerated this research.

The vaccines require two doses, spaced at 21 days (Pfizer-BioNTech) and 28 days (Moderna), and you can’t mix the vaccines. You get the shot in your upper arm, and side effects can include temporary soreness and redness at the injection site, localized lymph node swelling, fatigue, headache, muscle pain, joint pain, chills, nausea and vomiting, and fever, so you may need to take some acetaminophen afterwards. The side effects can be worse after the second shot, but it is very important that the two-shot series be completed.

There have been rare instances of severe allergic reactions, which can occur with any vaccine, and the clinic where you get it should be prepared for this. When enough people get the vaccine, (75-85% of population according to Dr. Anthony Fauci), we should reach herd immunity, but these numbers are likely a year away. Until we reach those numbers, you are still vulnerable if you haven’t been vaccinated.

Risk mitigation

Much of what we do in law enforcement is based on risk mitigation – that’s why we wear body armor, train in arrest control and driving techniques, and practice de-escalation strategies. What we do on an everyday basis in our interactions with the public, detainees or inmates puts us at significant risk for exposure to COVID-19, and though masks provide some limited protection, they do not provide the definitive protection that you will get from a vaccine. The CDC has recognized this, and that is why first responders are a high priority group for getting the vaccine, while the general public will be waiting several months to get theirs.

I look at the COVID-19 vaccine as another risk mitigation tool, kind of like ”internal body armor.” My risk of being shot is very low, yet if I am shot, I sure want to be wearing my body armor. Likewise, the risk of me dying or having complications from a COVID-19 infection is low, but if there is a way of eliminating that risk with a vaccine that is safe and effective, I am going to take the vaccine.

https://twitter.com/MNPDNashville/status/1343553729119875073

If you want to learn more, speak with your primary care physician and check out the resources below.

John M. Williams, Sr., MD, MPH, is a physician with a Master’s of Public Health degree, board-certified in both occupational medicine and ophthalmology. He is also a retired Navy medical officer, combat veteran and former Marine Corps Medical Battalion Commander. For the past 12 years, he has been a reserve deputy sheriff in southern Colorado and has also served as an academy instructor.

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